DenialIntel

Demo Environment — Synthetic Data OnlyThis application contains synthetic demonstration data only. Do not enter or submit patient information (PHI) or other sensitive personal information.
Members›policy B04M000545›PRIYA BAKER

PRIYA BAKER

Dependent on policy B04M000545

Claims
1
Attributed to this person
Charged
838.00
Total submitted
Denied
838.00
1 denied claims
Patient responsibility
0.00
Reported on the 835

Patient responsibility is the amount reported on the 835 as assigned to the patient — deductible, coinsurance or copay. It is not proof that the provider billed the member, that the member owes it, or that it was collected, and it is kept separate from denied amounts throughout.

Who this is

FieldValue
NamePRIYA BAKER
Role on the policyDependent · relationship 19
PolicyB04M000545
Date of birth12 Mar 2008
PlanBRONZE EPO
Covered from20 Jan 2024
Covered to9 Apr 2024

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00023979 Jan 2024838.00CASCADE CARECARC 26 · ELIGIBILITY838.00